How do you respond to clients who give critical feedback in therapy?
Today I want to talk about how to approach clients when they give us constructive, critical or uncalled for feedback in session.
I think it’s really helpful to have guidelines to guide us when we receive critical feedback in therapy from our clients. Of course, there are nuances that happen in each situation that we should take into account.
But, before we go any further, I want to remind you that my thoughts in this article do not constitute professional advice. If you are looking for support for how to receive and respond to specific client feedback, please seek out help from your consult group or from a supervisor.
Prefer to watch the video instead of read along? You can watch the episode here:
Extreme responses
Generally, I’ve noticed that therapists seem to lean more towards one extreme response or another when faced with critical feedback. Particularly if the therapist has any sort of personal insecurities.
Some therapists might lean towards the extreme of taking all, or nearly all, the responsibility for whatever the feedback is about. These therapists may find themselves apologizing immediately, or having an inner voice saying: “I should have known better.” or “Next time I’ll do it differently.”
On the other extreme, there are therapists who almost always take a more defensive posture. Sometimes a defensive posture really just means deflecting the responsibility back onto the client. They may say, “Oh this feedback is because of their presenting issue or pathology.” They ignore any context that might suggest that they may have played a part in the issue the client is bringing up.
If you can identify with one of these two ways of responding to critical feedback, then I encourage you to explore that in consultation or personal therapy. It’s important to take a genuine curious approach so that you can accurately understand what’s going on when you respond in these ways.
While I don’t think leaning into those extremes applies to all therapists, I do think we are prone towards leaning towards one side or the other when we’re in a place of feeling insecure and unstable. Typically, when folks are grounded and healthy they don’t fall into the extreme responses.
Guidelines
Let’s dive into the guidelines that I like to utilize when I receive constructive feedback from a client. Some of these guidelines are going to feel like complete common sense. But, I am going to list all of them, for the sake of being thorough.
And, depending on the type and content of the feedback you receive, you may use all or only a few of these guidelines. Sometimes a quick conversation about the feedback is sufficient. Other times a half hour dialogue is appropriate. Use your judgement on what feels right in each case.
1) Listen
- This one might sound obvious!
- But, when we are in a situation when we are feeling on edge we might not hear the client out fully. We may rush to defend or apologize.
- Even if we accurately perceive the feedback our client is giving, jumping to respond may leave the client feeling unheard and frustrated.
2) Validate the feedback
- After listening, tell your client you are thankful they spoke up and shared their feedback.
- The reason I like to start with this is because almost all of us feel really uncomfortable giving feedback.
- Even if, in your mind, the feedback is absolutely unfounded, it is still important to acknowledge that it probably feels uncomfortable for your client to voice their concerns.
3) Be curious
- Genuinely try to tap into curiosity when you ask follow-up questions.
- Ask your client for specifics and to tell you more.
- I think your client can sense, from your questions, if you are genuinely trying to understand their concerns better.
- If we lead with defensiveness, or from insecurity then it is possible our clients will sense that and back down from sharing their feedback because they don’t feel safe to do so.
4) Invite feedback
- We also want to make sure that our questions include invitations for feedback.
- For example: “What sorts of things can I work on or change to improve the situation?” or “What sorts of things could I have done differently so that I can learn for next time?”
- Many times the initial concerns that were raised were only a small part of what the client is feeling and hopes to share. They are testing to see if it is safe enough to share more.
- Asking specific, leading questions about the area of concern can help your client feel comfortable to articulate more of what they are feeling.
- For example, you might say: “I remember when we had that conversation (from which the concern stemmed), I asked you this question: ____, I’m curious how that landed for you? Is that an example of what you’re talking about? How could I have approached that situation differently?”
5) Take responsibility
- This is now your time to take responsibility for your part. Your part may be big or your part may be very small.
- If there is an apology warranted, this would be the time to make the apology.
- It’s helpful to say more than: “I’m sorry.” It is important to acknowledge specifically what you did wrong and how you see that has negatively affected your client.
- Or, let’s say that your client is giving you feedback that a specific wording you used made them feel a certain way. Owning your part in this kind of situation would sound like: “Wow, I can see now, given [X,Y,Z] when you heard me say that, that was so painful.”
- It is your responsibility to acknowledge how your actions affected your client, even if you didn’t do anything wrong.
6) Collaborate together
- When you feel like you’ve taken ownership for whatever part you played, then it’s a good time to collaborate on any changes to make together going forward.
- If there is anything that you might have messed up on, or you might want to change going forward you can identify that together.
- This would also be the time to identify and discuss approaching things differently on your client’s end. Maybe they had cognitive distortion, they catastrophized, or they blew up at you.
- Try to discuss specifics of what this will entail.
7) Consider real life application
- Now, it’s helpful to pause and zoom out and see if there’s anything about what happened in that feedback experience that might also apply in the client’s regular life outside of therapy.
- This could be framed in some questions: “What was this like for you? Are there any moments in the rest of your life where you feel like you have similar feedback to give someone? Or any similar hurtful experiences?”
- It’s helpful to find the parallels between this feedback conversation and their real life experiences.
- Ask: “Is there anything about this that would be helpful to bring with you or apply in life outside?”
8) Follow-Up
- At the next session, follow-up with your client.
- I might say: “Hey, we had a big conversation last time. You gave me some feedback. Again, I’m so glad you did that. How was that for you? Here’s our plan going forward. Does that still feel all right?”
- Continue to follow-up whenever a similar situation occurs. For example, if the feedback was about a certain type of conversation, then the next time you have that type of conversation ask how they felt you approached it that time.
Now that we’ve covered some of those best practices guidelines for how to approach receiving critical feedback in therapy, let’s talk a bit about what not to do.
How NOT to respond to critical client feedback
I know it’s easy to think of the big things of what not to do. Don’t yell. Don’t lash out at your client. But, there are sneaky ways that we can be quite unhelpful or even harmful in how we respond to our clients even when it comes in pretty flowery packaging.
1) Being defensive
- I think we commonly think of defensiveness as reacting with: “I didn’t do that!” or “You don’t understand!”
- Sometimes defensiveness can still come through in a veiled way. For example: “I’m really surprised that you’re only just now bringing that up because I’ve been doing it that way for months now.”
2) Being condescending
- Again, we can all call to mind some vivid examples of what it looks like to be condescending.
- But, there are subtle ways that condescension can creep in.
- It can sound something like: “Oh, I didn’t realize that my benign comment would trigger your sensitivity so much.”
3) Attacking the client
- We can go there. If we are capable of attacking people we care about, we are capable of attacking our clients too.
- It might sound like: “Oh, you always do this. Here’s that problem again.”
- Again, it’s this dynamic of subtly putting everything back on the client as their problem.
- This can be incredibly unhelpful and may even serve to worsen whatever it is your client is looking for help from you for.
4) Denying the claim
- Straight up denying the claim isn’t going to help move things forward, even if what they’re claiming is objectively false.
- If you’re not seeing eye to eye on whatever your client is coming forward with, then you can say things like: “I’m having trouble fully understanding what you’re describing. Can you help me fill in some of the blanks?” or “Here are some of the holes that I’m seeing. I don’t think I’ve caught up with what you’re saying quite yet.”
- Maybe some clarification is all it takes to get on the same page.
- Or, maybe, even after clarifications you still can’t see where your client is coming from, or you have hard data to show that what your client is claiming is not true.
- If so, rather than denying their claim, it’s more helpful to say: “Wow, how interesting! I really remember the situation going like this: _____ but, you have this really different memory. How do we talk about this given that we’re really remembering this differently?”
Well, that sums up my general approach to receiving critical feedback in therapy from a client. Especially more significant kinds of feedback that are hard to hear.
It’s hard to hear constructive feedback! But, let’s keep in mind that it’s hard to give critical feedback in therapy too.
The hope is that these guidelines are helpful regardless of whether the responsibility falls on your end or the clients’. Or some mixture of both. The goal is that you can more accurately and effectively problem solve, make changes, and move forward.
More therapy skills
As a therapist there are countless scenarios that you may run into with your clients besides receiving constructive feedback. You probably have a long list of examples ready to go.
Have an angry client? Here are my go-to approaches for dealing with an angry client.
Do you have a client who is demonstrating resistance? I have an article about 4 therapy approaches to try with a resistant client.
Of course, one of our main goals as therapists is to create a safe and supportive environment for our clients. I have a video with 13 ways to foster safety with clients.
This kind of environment will create a place where clients feel comfortable being honest with you about any feedback they might have.
Until next time, from one therapist to another: I wish you well.
-Marie
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